Mexico Visa Application Form

Secretaría de Relaciones Exteriores
Visa Application Form
Photo Consular Office Reference Number
AXU3257589
Office use only

Each applicant must fill out their own copy of this form.
TYPE or PRINT in black ink.
I. Personal Information
1. Given name(s): JAI PAL

Esta solicitud es de distribución gratuita
(As shown on passport or travel document)

2. Surname(s):
(As shown on passport or travel document)
4. Sex: Female Male

5. Date of Birth: / / / 6. Age:
DD MM YYYY
7. Country/ territory of birth: 8. Nationality: IND
9. Passport/ Travel Document Number: U6985660
a) Issuing country: b) Date issued: / / /
DD MM YYYY
c) Date of expiry: / / /
DD MM YYYY
II. Additional Information

Type of Visa (check category that applies):
10. Marital status: single married common law
11. Current residential address: o Visitor/ Tourist

12. Phone number (include area code): 13. E-mail address: o Long-term Visitor/Tourist
o Work Visa
14. Occupation:
o Visitor conducting adoption
15. Company name or institution: proceedings
16. Country of residence: 17. Legal migratory status: Yes No o Student
o Temporary Residence
18. Have you ever been convicted of a criminal offence in Mexico/ other country? Yes No o Permanent Residence
19. If you selected YES, please provide an explanation: o Diplomatic
o Official
o Service
III. Purpose and Information of your Travel
Passport Type:
20. Date you plan to travel to Mexico: / / / Regular Special Laissez-Passer
DD MM YYYY
21. City/ state of entry:

22. Length of stay in Mexico: Less than 180 days
Between 180 days and 4 years
Definitive Notes:
23. Have you visited Mexico before? Yes No
24. Have you ever been ordered to leave Mexico? Yes No
25. If you selected YES, please provide an explanation:
26. What is the purpose of your visit to Mexico?
Contacto:
Avenida Ricardo Flores Magón no. 2, piso 3, Col. Guerrero, Delegación Cuauhtémoc,
C.P. 06300, Ciudad de México.
Teléfono: (55) 3686 - 5100
Correo electrónico: dgsconsulares@sre.gob.mx
Secretaría de Relaciones Exteriores
IV. Minors/ Dependents

Parents or legally-appointed guardians must fill an application form on behalf of their minor children. Forms must be signed by both parents, and person(s) who hold
custody/ legal guardianship. If a visa application is presented by only one parent/guardian, said parent must provide a notarized authorization letter, which demonstrates
that the non-accompanying parent consents to the visa application process on behalf of his/her child/children.
Minors applying on their own, or accompanied by a third party over the age of 18, must provide a letter of consent, signed by both parents and/or person(s) who exercise
custody/ guardianship. It is mandatory to have the letter of consent notarized by a Notary Public or entity legally authorized to provide services in the jurisdiction.
V. List of Supporting Documents Attached to this Application
1)
2)
3)
4)
5)
The information hereby provided/attached is truthful, complete and correct. If an applicant provides false or conceals information, and/or submits
Esta solicitud es de distribución gratuita
documents that are in any way altered, falsified or obtained through fraudulent means will be denied any visa to enter Mexico, and subsequently
registered in migratory databases.
In accordance to Mexican immigration laws and regulations, a Mexican visa allows a foreign national to arrive at a port of entry and/or migration
checkpoint, and request entry into Mexico. Be advised that holding/ presenting a visa does not guarantee that entry into Mexican territory will be
granted. At the point of entry, Mexico's immigration officers are the only authority that can accept or refuse the entry of any traveller into Mexico,
regardless of whether the traveller has previously attained a visa or is exempt from obtaining one.
The information and supporting documents collected for this application are considered confidential and protected by federal law, as mandated by
Federal Law on Protection of Personal Data Held by Individuals. Further details on this matter are available at http://sre.gob.mx/avisos-de-privacidad.
Date and Place
Place: Date: / /
DD MM YYYY
Applicant’s Name and Signature Parent/ Guardian’s Name and Signature Parent/ Guardian’s Name and Signature
(Minors/ dependents only) (Minors/ dependents only)
Recibió Entrevistó Capturó

(Nombre y firma de quien recibe la solicitud) (Nombre y firma del funcionario que entrevista) (Nombre y firma de quien captura)
Autorizó
El (la) suscrito(a) hace constar que los documentos anexados a este
expediente han sido validados a mi juicio y, por ello, autorizo.
Contacto:
Avenida Ricardo Flores Magón no. 2, piso 3, Col. Guerrero, Delegación Cuauhtémoc,
C.P. 06300, Ciudad de México.
Teléfono: (55) 3686 - 5100
Correo electrónico: dgsconsulares@sre.gob.mx

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Mexico Visa Application Form

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Secretaría de Relaciones Exteriores

Visa Application Form

Photo Consular Office Reference Number

Office use only

1. Given name(s): JAI PAL

(As shown on passport or travel document)

4. Sex: Female Male

II. Additional Information

11. Current residential address: o Visitor/ Tourist

21. City/ state of entry:

IV. Minors/ Dependents

V. List of Supporting Documents Attached to this Application

Date and Place

Recibió Entrevistó Capturó

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